Systematic review of brucellosis in the Middle East: disease frequency in ruminants and humans and risk factors for human infection.

A systematic review of studies providing frequency estimates of brucellosis in humans and ruminants and risk factors for Brucella spp. seropositivity in humans in the Middle East was conducted to collate current knowledge of brucellosis in this region. Eight databases were searched for peer-reviewed original Arabic, English, French and Persian journal articles; the search was conducted on June 2014. Two reviewers evaluated articles for inclusion based on pre-defined criteria. Of 451 research articles, only 87 articles passed the screening process and provided bacteriological and serological evidence for brucellosis in all Middle Eastern countries. Brucella melitensis and B. abortus have been identified in most countries in the Middle East, supporting the notion of widespread presence of Brucella spp. especially B. melitensis across the region. Of the 87 articles, 49 were used to provide evidence of the presence of Brucella spp. but only 11 provided new knowledge on the frequency of brucellosis in humans and ruminants or on human risk factors for seropositivity and were deemed of sufficient quality. Small ruminant populations in the region show seroprevalence values that are among the highest worldwide. Human cases are likely to arise from subpopulations occupationally exposed to ruminants or from the consumption of unpasteurized dairy products. The Middle East is in need of well-designed observational studies that could generate reliable frequency estimates needed to assess the burden of disease and to inform disease control policies.

Herd contact structure based on shared use of water points and grazing points in the Highlands of Ethiopia.

The use of shared common water points (WPs) and grazing points (GPs) at two different levels of administrative aggregation (village and kebelle) in a region of the Highlands of Ethiopia was explored by means of a questionnaire survey and social network analysis. Despite GPs being more abundant than WPs (208 and 154, respectively), individual GPs provide more contact opportunities for animals. There was great variability in the contact structure of the selected villages within kebelles for both networks, with this variability being higher in the GP networks for each kebelle. Contrary to the commonly held view that WPs are critical for the potential transmission of infectious diseases, intervention at GPs in the Ethiopian Highlands may have greater impact on contacts and thereby opportunities for transmission of infectious diseases between flocks. Some villages appear naturally at much lower risk of introducing disease. These findings could help the design of surveillance and control activities for directly transmitted infectious diseases.

Assessment and simulation of the implementation of brucellosis control programme in an endemic area of the Middle East.

Brucellosis is an important zoonosis in Middle Eastern countries. In this study we assessed the extent of the application of planned official brucellosis control programmes in Kafr El Sheikh governorate, Egypt and we used a stochastic simulation model to assess the probable impact of changes to the official control strategy on the dynamics of small-ruminant brucellosis. Our results show that <7% of female livestock were tested in any given year in the study area and that quarantine was not consistently applied to infected herds. Simulation results revealed the inability of the applied control measures to reduce the prevalence of small-ruminant brucellosis. Given our assumptions, the intensity with which infected animals are removed under the actual levels of implementation of test-and-slaughter programmes would permit brucellosis to remain endemic at a level >8% of the sheep and goat population.

Contamination of food products with Mycobacterium avium paratuberculosis: a systematic review.

Although a causal link between Mycobacterium avium subspecies paratuberculosis (MAP) and Crohn's disease has not been proved, previous studies suggest that the potential routes of human exposure to MAP should be investigated. We conducted a systematic review of literature concerning the likelihood of contamination of food products with MAP and the likely changes in the quantity of MAP in dairy and meat products along their respective production chains. Relevant data were extracted from 65 research papers and synthesized qualitatively. Although estimates of the prevalence of Johne's disease are scarce, particularly for non-dairy herds, the available data suggest that the likelihood of contamination of raw milk with MAP in most studied regions is substantial. The presence of MAP in raw and pasteurized milk has been the subject of several studies which show that pasteurized milk is not always MAP-free and that the effectiveness of pasteurization in inactivating MAP depends on the initial concentration of the agent in raw milk. The most recent studies indicated that beef can be contaminated with MAP via dissemination of the pathogen in the tissues of infected animals. Currently available data suggests that the likelihood of dairy and meat products being contaminated with MAP on retail sale should not be ignored.

Risk associated with animals moved from herds infected with brucellosis in Northern Ireland.

The movement of cattle from herds infected with Brucella abortus was investigated in order to assess the control measures for eradication of brucellosis from the cattle population of Northern Ireland. Using recorded cattle movement data, a historical cohort study was designed and carried out to quantify the risk of seropositivity in bovine animals moved from herds infected with brucellosis. The study found that 3.1% of animals, moved in the 6-month period prior to disclosure of infection in the source herd and subsequently tested, were interpreted as seropositive in their destination herds. The odds of seropositivity were approximately 19 (95% confidence interval: 7.8-46.4) times higher in this cohort compared with animals from herds with no history of infection. A multivariate logistic regression model was constructed to examine factors influencing the risk of seropositivity in the exposed cohort of animals, identifying maternal status (whether the dam had been a brucellosis reactor) and age at leaving the infected herd as the main risk factors.

Effect of introducing piglets from farrow-to-finish breeding farms into all-in all-out fattening batches in Spain on productive parameters and economic profit.

A prospective study was conducted to assess the effect of introduction of piglets from farrow-to-finish farms on the global performance of all-in all-out fattening batches in Galicia (NW Spain). Two hundred and thirty-nine fattening batches from 48 fattening farms integrated in a cooperative were used in the study. All-in all-out fattening batches were classified according to the category of farm that supplied the piglets. Origin F was a fattening batch where all feeder piglets came from one or more farrow to feeder units versus origin FF, in case a group of piglets or all piglets of the batch came from farrow-to-finish farms. Productive parameters of fattening batches included in the study were recorded. Crude comparisons of performance of 37 fattening batches from origin F and 202 from origin FF were made. Mixed multiple linear regression models were used to assess the association between type of origin of feeder piglets and the following parameters: feed consumed per market hog, percentage of deaths (mortality) and time to slaughter. In all models, variables with presumable relationships with the outcomes were offered to the models as well as the biologically plausible interaction terms. Mortality was higher in fattening batches with piglets coming from farrow-to-finish farms (0.67% higher than origin F; P<0.05). Time to slaughter was longer when feeder piglets were from origin FF (3.1 days longer; P<0.05). We found a significant effect of type of origin on feed consumed per marketed hog. Additionally, a significant interaction was found: feed consumed per marketed hog was higher for fattening batches with all piglets from farrow-to-finish farms if slaughtered before 109 days and vice versa. A Monte Carlo simulation model was used to assess the economic impact of using origin F or FF as source of piglets. Results of the model indicated that the difference in expected profit per marketed hog between the types of sources of piglets was small (11.50 Euros, S.D. 1.79 for origin F versus 10.44 Euros, S.D. 2.72, for origin FF).

Space-time interaction as an indicator of local spread during the 2001 FMD outbreak in the UK.

During the 2001 FMD outbreak in the UK, decisions on the level of implementation of control measures were supported by predictive models. Models were mainly used as macro-level tools to predict the behaviour of the disease in the whole country rather than at the local level. Here we explore the use of the magnitude and characteristics of the space-time interaction as an indicator of local spread and, indirectly, of the effectiveness of control measures aimed at reducing short-range transmission during the course of a major livestock disease epidemic. The spatiotemporal evolution patterns are described in the four main clusters that were observed during the outbreak by means of the hazard rate and space-time K-function (K(s,t)). For each local outbreak, the relative measure D(0)(s,t), derived from K(s,t), which represents the excess risk attributable to the space-time interaction was calculated for consecutive 20-day temporal windows to represent the dynamics of the space-time interaction. The dynamics of the spatiotemporal interaction were very different among the four local clusters, suggesting that the intensity of local spread, and therefore the effectiveness of control measures, markedly differed between local outbreaks. The large heterogeneity observed in the relative impact of being close in time and space to an infected premises suggests that the decision making in relation to control of the outbreak would have benefited from indicators of local spread which could be used to complement global predictive modelling results. Despite its limitations, our results suggest that the real-time analysis of the space-time interaction can be a valuable decision support tool during the course of a livestock disease epidemic.

Conceptual framework for avian influenza risk assessment in Africa: the case of Ethiopia.

The avian influenza (AI) epidemic is threatening Africa mainly because the flyways of migratory birds link the endemic and newly infected countries with disease-free areas in this continent and because of the risk of introduction through trade. Risk analysis provides a set of tools for supporting decision making by the veterinary services and other stakeholders, resulting in more effective surveillance and emergency preparedness. The risk assessment process could be split into three different steps: 1) risk release through the migratory birds and the official and unofficial poultry-product marketing chains; 2) risk exposure by means of studying interfaces among imported and exposed poultry and among wild and domestic birds; and 3) risk consequences for establishing the probability of AI spreading within the poultry population and the probability of it escaping detection. A conceptual framework is presented based on preliminary data and field missions carried out in Ethiopia. Field surveys and expert opinion will be necessary for the parameterization of the risk model. Spatial analysis will be used to identify high risk of exposure among wild and domestic birds. Risk communication and risk management will be based on the findings from the risk assessment model.

Use of social network analysis to characterize the pattern of animal movements in the initial phases of the 2001 foot and mouth disease (FMD) epidemic in the UK.

Aggregated movement data do not take into account the relative position of the units within a higher-level structure. Social network analysis (SNA) and graph theory provide a tool to organise and analyse relational data overcoming the limitations of standard methods where the position of individuals/observations does not affect the result of the analysis. Some recorded movements of cattle and sheep during the initial phase of the 2001 foot and mouth disease (FMD) outbreak in the UK, before the ban on animal movements was imposed, are analysed descriptively using SNA. With the data available, a directed dichotomized network with 653 nodes and 797 arches was analysed. Most of the 10 nodes with the highest betweenness (3 farms, 4 markets and 3 dealers) were identified as key players in the initial spread of the infection. Three groups of nodes with distinctive proportion of k < or = 2 neighbours would result in three different theoretical outbreak dimensions assuming that the infection is only disseminated by the movements included in the network: no spread, spread up to 7% and around 25%. There are three hierarchical clusters with 308, 215 and 130 nodes, respectively. Farms in cluster 1 appear to be more similar in their movement patterns to non-farm holdings than to farms in clusters 2 and 3. Relative betweenness, k-neighbours and structural equivalence using hierarchical clustering were able to identify key actors in the evolution of the initial phases of the FMD outbreak such as markets, dealers and farms with atypical movement patterns. Holdings with high betweenness, large number of k < or = 2 neighbours and with movement pattern as in cluster 1 should be targeted in disease control activities once primary actors like markets, dealers and slaughter houses have been contained.

Evidence of bias affecting the interpretation of the results of local anaesthetic nerve blocks when assessing lameness in horses.

Eighteen observers were influenced to different extents in the grades of lameness they allocated to eight horses by whether they knew that a nerve block had been administered; on a scale from 0 to 10 the mean difference in grade allocated once the observer knew a horse had been nerve-blocked was increased by 0.4. The consistency of the assessments made by the individual observers was good, with a an average of 0.6 of a grade difference when grading the same horse on two occasions. The agreement between the assessments of four orthopaedic experts was reasonable (+/-1 grade), but significantly poorer for four non-experts and 10 final year veterinary students.

Serological study of the frequency of leptospiral infections among dairy cows in farms with suboptimal reproductive efficiency in Galicia, Spain.

Between March 1996 and September 1997, 15 farms located in Galicia (NW Spain) and experiencing suboptimal reproductive efficiency were visited and blood samples were obtained from all the lactating cows (n=442). Additionally, 1060 samples were obtained monthly from a cohort of 219 lactating cows belonging to nine of the farms between March 1996 and April 1997. All the samples were tested by microscopic agglutination (MAT) using live antigens representing the following Leptospira interrogans serogroups: Australis, Autumnalis, Ballum, Canicola, Grippotyphosa, Icterohaemorrhagiae, Louisiana, Pomona, Sejroe, Shermani and Tarassovi. Eighty-one of the 442 cows were positive against one or more serogroups (P=18.33%). Serologically, L. bratislava and L. grippotyphosa were detected as the most prevalent serovars (P=7.92 and 7.69%, respectively) and as the serovars against which the probability of seroconversion was highest (P=0.27 and 0.25, for a 12-month period, respectively) among those studied. The proportional hazards regression method was used for evaluating the seasonal trend of seroconversions against these two serovars. The risk of seroconversion against L. grippotyphosa was significantly higher during spring. The risk of seroconversion against L. bratislava did not differ significantly among seasons. Our results suggest that infections by L. bratislava did not follow, among the study animals and during the study period, the pattern typically described for non-adapted serovars, pointing out the possibility that some strains of this serovar could behave as adapted serovars.

Ixodes hexagonus is the main candidate as vector of Theileria annae in northwest Spain.

Babesia canis and Babesia gibsoni have, until recently, been considered the only piroplasms that parasitise dogs. However, recent reports indicate that "small" Babesia infections in Spanish dogs are surprisingly frequent and molecular phylogenetic analysis indicates that the infecting agent is closely related to Babesia microti. Because the 18SrDNA sequence was not completely identical to that of B. microti, the new name "Theileria annae" was assigned to the canine agent. No information is available regarding the possible vector of the new piroplasm, T. annae. As part of an effort to identify the tick that may transmit T. annae in northwest Spain we asked veterinary surgeons practising in the region to collect and send to our laboratory ticks from dogs visiting their clinics. Seven hundred and twenty ticks collected from dogs of unknown clinical status during 1998 and 636 ticks collected between November 2001 and March 2002 from 38 dogs infected with T. annae and 131 uninfected dogs were identified. Results from the first study indicated that among the Ixodidae, Ixodes hexagonus clearly predominates over Ixodes ricinus (26.11% versus 6.67%). This observation was consistent with results of the second study, in which I. hexagonus was detected in all infected dogs and 71.8% of non-infected dogs and I. ricinus was not detected in either the infected or non-infected dogs. Results from the 2001-2002 study also indicate that the presence of Dermacentor reticulatus adult females is significantly less frequent among infected than non-infected dogs (OR=0.44; 95% CI: 0.21-0.92). On the other hand, I. hexagonus adult females and males are 6.75 and 4.24 times more likely to be detected among infected than non-infected dogs, respectively, with the association being, in both cases, statistically significant (95% CI: 1.97-23.12 and 1.92-9.36, respectively). I. hexagonus emerges as the main candidate as vector of T. annae because it feeds on dogs more frequently than other ticks and because B. microti is transmitted by Ixodes ticks, both in North America and Europe. In the absence of definitive confirmation of this hypothesis, our observations suggest that I. hexagonus might serve the same role as does Ixodes scapularis (=Ixodes dammini), the vector of B. microti in eastern North America.

Case-control study of canine infection by a newly recognised Babesia microti-like piroplasm.

We did a case-control study to identify risk factors for prevalent infection of dogs by a newly recognised Babesia microti-like piroplasm. Clinical manifestations and haematology of infected dogs also were described. Forty-three laboratory-based cases and 86 individually matched controls were studied. Information on clinical signs and on risk factors was collected by a questionnaire and telephone interviews. Haematology was carried out for all the dogs. Variables were screened in a bivariable conditional logistic regression and checked for colinearity. The final multivariable model was selected by backward stepwise elimination. The odds of a case having ticks when examined at the clinic was 4 times that of a control and the odds of a case being a hunting or a house-guarding dog were, respectively, 24.2 and 2.7 times those of a control. The most consistently reported clinical signs were weakness (79%), tachycardia (43%) and haemoglobinuria (42%). Mean red-blood-cell count, haemoglobin concentration, platelet count, and mean platelet volume of infected dogs were lower than the reference values and those of non-infected dogs-but leukocyte count, mean corpuscular volume and red-blood-cell distribution width were higher.

Relationships between bulk-tank antibodies to Ostertagia ostertagi and herd-management practices and measures of milk production in Nova Scotia dairy herds.

Monthly bulk-tank milk samples were obtained from 415 Nova Scotia dairy herds in each of the months of July-September 1998 and tested using an indirect microtitre ELISA against a crude saline-extract, whole-worm Ostertagia ostertagi antigen. ELISA results (optical densities (ODs)) were consistent across months (r=0.85) but there was considerable variation among herds. A questionnaire was sent by mail to all producers; information on management factors that would potentially influence parasite burdens in the herds was obtained from 239 farms. Data on annual milk production, summer milk production (July-September) and seasonal decline in milk production were obtained from the Animal Productivity and Health Information Network (APHIN) database. Associations between management practices and ODs, and between ODs and milk-production parameters were studied. Some management practices known to be associated with parasite burdens had expected directions of association with the ODs, giving supporting evidence that the ELISA is a reasonable measure of parasite burden. Most notably, ODs were increased with greater exposure of heifers or milking cows to pasture. ODs were not associated with either annual milk production or seasonal decline in milk production. However, there was a substantial relationship between the herd OD value and the level of milk production during the summer. An increase in the OD from 0.58 to 0.83 (the interquartile range of ODs) was associated with a reduction in production of 1.25kg/cow/day.

Infection of dogs in north-west Spain with a Babesia microti-like agent.

During 1996 a small, ring-shaped, piroplasm was observed in blood smears from 157 dogs in north-west Spain. None of them had previously been in areas endemic for Babesia gibsoni, which was until recently the only small piroplasm known to parasitise dogs. Haematological and serum biochemistry analyses showed that almost all the dogs had an intense regenerative haemolytic anaemia and that in some cases there was evidence of renal failure. A molecular study was made of a sample of the parasite obtained in June 2000. The phylogenetic analysis showed an identity of 100 per cent with the new piroplasm, provisionally denominated as Theileria annae, and 99 per cent with Babesia microti and B. microti-Japan. The results confirm the previous observation of a new form of piroplasm (Theileria annae) which causes disease in dogs in Europe and suggest that it is endemic among the canine population in north-west Spain.

Babesia canis infection in a splenectomized dog.

The present report describes a fatal case of non-experimental babesiosis in a splenctomized 3-year-old fox terrier. A very intense parasitaemia including clusters of up to 16 Babesiae and a prominent haemophagocytic activity were the most relevant findings. A marked leukocytosis, thrombocytopenia and regenerative anaemia were observed. Despite prompt treatment with babesiacidal compounds the condition progressed to acute renal failure and resulted in the death of the animal 48 hours after the onset of symptoms.

Angiostrongylus vasorum in Great Britain: a nationwide postal questionnaire survey of veterinary practices.

The lungworm, Angiostrongylus vasorum, was first reported in indigenous dogs in southwestern England in 1980 and has since been recorded in Wales, southeastern England and, more recently, in the West Midlands, northern England and Scotland. The nationwide distribution of the parasite was evaluated using a postal questionnaire sent to 3950 small animal practices during 2009. Information was sought on the location of each practice, awareness of the parasite locally, number of cases diagnosed over the past year and whether diagnosis was based on clinical signs alone or supported by additional tests. 1419 practices returned a usable response, the majority being located in a city/town. Nearly one-third of responding practices were aware of the parasite locally, 20.7 per cent had seen at least one confirmed case and 0.3 per cent >20 confirmed cases over the past year. The most widely used tests were faecal examination and any type of imaging. Existing clusters of infection were detected in southeastern England and south Wales; infection was also found to be widespread in central England, though patchy in northern England and Scotland. Using distribution of clinical cases as an indicator of parasite distribution, this study confirmed that A. vasorum has spread beyond traditional UK endemic foci.

Spatial, demographic and clinical patterns of Angiostrongylus vasorum infection in the dog population of Southern England.

A retrospective study was carried out to provide updated knowledge of the spatial pattern of Angiostrongylus vasorum infection in Southern England and to investigate associations between selected host characteristics (age, breed, sex), risk of infection and clinical presentation (cardiorespiratory signs v haemorrhagic diathesis). One hundred and forty-one cases diagnosed between April 1999 and July 2012 were compared with a control population of dogs referred to the same hospital. A significant association was found between haemorrhagic diathesis and breed but not for other host characteristics and clinical presentations. Younger dogs and certain breeds of dog (Jack Russell terriers, Cocker Spaniels, Springer Spaniels, Cavalier King Charles spaniels and Staffordshire Bull Terriers) had significantly higher odds of angiostrongylosis than other breeds in the study. A significant cluster of cases was found in Southern England. Animals presenting with cardiorespiratory signs or haemorrhagic diathesis in Southern England, especially if they are young or of a breed associated with angiostrongylosis, should be given special consideration with regards to possible A. vasorum infestation. Our results should be interpreted bearing in mind that they are based on the retrospective exploration of dogs seen at a referral centre.

Impact of the implementation of rest days in live bird markets on the dynamics of H5N1 highly pathogenic avian influenza.

Live bird markets (LBMs) act as a network 'hub' and potential reservoir of infection for domestic poultry. They may therefore be responsible for sustaining H5N1 highly pathogenic avian influenza (HPAI) virus circulation within the poultry sector, and thus a suitable target for implementing control strategies. We developed a stochastic transmission model to understand how market functioning impacts on the transmission dynamics. We then investigated the potential for rest days-periods during which markets are emptied and disinfected-to modulate the dynamics of H5N1 HPAI within the poultry sector using a stochastic meta-population model. Our results suggest that under plausible parameter scenarios, HPAI H5N1 could be sustained silently within LBMs with the time spent by poultry in markets and the frequency of introduction of new susceptible birds' dominant factors determining sustained silent spread. Compared with interventions applied in farms (i.e. stamping out, vaccination), our model shows that frequent rest days are an effective means to reduce HPAI transmission. Furthermore, our model predicts that full market closure would be only slightly more effective than rest days to reduce transmission. Strategies applied within markets could thus help to control transmission of the disease.

Ruminant brucellosis in Upper Egypt (2005-2008).

Brucellosis is endemic among humans and ruminant in Egypt and recent reports suggest that its incidence may be increasing. In this study we describe the frequency of brucellosis among different ruminant species in Upper Egypt and its spatial distribution using the data generated by a large-scale control campaign undertaken between 2005 and 2008. A total of 120,090 individual animals of different ruminant species were tested during the campaign. The true proportions of brucellosis were estimated as 0.79% (CI: 0.71%-0.87%), 0.13% (CI: 0.08%-0.18%), 1.16% (1.05%-1.27%) and 0.44% (0.34%-0.54%) among cattle, buffaloes, sheep and goats respectively. We estimated that 0.2% (CI: 0.16%-0.23%) of households in the study area keep at least one seropositive animal. Spatial autocorrelation of the proportions of seropositive households and seropositive animals was assessed using Global Univariate Moran's I and Local Univariate LISA. These analyses showed that the distribution of seropositive animals has considerable spatial heterogeneity with clustering in the northern governorates of the study area. Our results show that brucellosis is widespread and heterogeneously distributed in Upper Egypt. At the current level of available resources it is very unlikely that test and slaughter could be implemented with the intensity needed to be effective and other control measures that could replace or complement the test and slaughter policy in place should be considered. Also, this study illustrates some of the challenges faced by bilateral projects that have to accommodate an externally funded intervention with an ongoing national official disease control program.